Name: Al Kim P.

Paglinawan BPED-IV

CARDIOPULMONARY RESUSCITATION (CPR)

Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in many
emergencies, including a heart attack or near drowning, in which someone's breathing
or heartbeat has stopped. The American Heart Association recommends that everyone
— untrained bystanders and medical personnel alike — begin CPR with chest
compressions.

Importance of CPR
Statistics indicate that 70%-80% of cardiac arrest cases occur either in the home or at
public places. In such cases, the person nearest at hand to the victim is often a bystander
with no medical expertise such as a relative, an office colleague, or a passer-by. If those
present at the scene are able to provide CPR to the victim promptly, the latter’s chances
of survival are significantly increased.

This is because time is the essence when treating a cardiac arrest victim. Once the heart
stops beating and blood flow stops, a person will lose consciousness within 15 seconds.
Within another 30 to 60 seconds, he will stop breathing, and irreversible damage to his
brain cells will follow after several minutes of oxygen deprivation.

The Singapore Heart Foundation’s Heart Safe mission is to improve the out-of-hospital
sudden cardiac arrest survival rate in Singapore by creating an environment for more
effective use of CPR and Automated External Defibrillators (AED) in the community
through various initiatives.

It's far better to do something than to do nothing at all if you're fearful that your
knowledge or abilities aren't 100 percent complete. Remember, the differences
between you’re doing something and doing nothing could be someone's life.
Here's advice from the American Heart Association:

 Untrained. If you're not trained in CPR, then provide hands-only CPR. That
means uninterrupted chest compressions of 100 to 120 a minute until paramedics
arrive (described in more detail below). You don't need to try rescue breathing.
 Trained and ready to go. If you're well-trained and confident in your ability,
check to see if there is a pulse and breathing. If there is no breathing or a pulse
within 10 seconds, begin chest compressions. Start CPR with 30 chest
compressions before giving two rescue breaths.
 Trained but rusty. If you've previously received CPR training but you're not
confident in your abilities, then just do chest compressions at a rate of 100 to 120 a
minute. (Details described below.)
The above advice applies to adults, children and infants needing CPR, but not new-
borns (infants up to 4 weeks old).
CPR can keep oxygenated blood flowing to the brain and other vital organs until more
definitive medical treatment can restore a normal heart rhythm.
When the heart stops, the lack of oxygenated blood can cause brain damage in only a
few minutes. A person may die within eight to 10 minutes.
To learn CPR properly, take an accredited first-aid training course, including CPR and
how to use an automated external defibrillator (AED). If you are untrained and have
immediate access to a phone, call 911 or your local emergency number before
beginning CPR. The dispatcher can instruct you in the proper procedures until help
arrives.
Before you begin
Before starting CPR, check:

 Is the environment safe for the person?

 Is the person conscious or unconscious?
 If the person appears unconscious, tap or shake his or her shoulder and ask
loudly, "Are you OK?"
 If the person doesn't respond and two people are available, have one person call
911 or the local emergency number and get the AED, if one is available, and have
the other person begin CPR.
 If you are alone and have immediate access to a telephone, call 911 or your local
emergency number before beginning CPR. Get the AED, if one is available.
 As soon as an AED is available, deliver one shock if instructed by the device,
then begin CPR.
Remember to spell C-A-B

Chest compressions Open the airway Rescue breathing

The American Heart Association uses the letters C-A-B — compressions, airway,
breathing — to help people remember the order to perform the steps of CPR.
Compressions: Restore blood circulation

1. Put the person on his or her back on a firm surface.

2. Kneel next to the person's neck and shoulders.
3. Place the heel of one hand over the center of the person's chest, between the
nipples. Place your other hand on top of the first hand. Keep your elbows straight
and position your shoulders directly above your hands.
4. Use your upper body weight (not just your arms) as you push straight down on
(compress) the chest at least 2 inches (approximately 5 centimeters) but not
greater than 2.4 inches (approximately 6 centimeters). Push hard at a rate of 100
to 120 compressions a minute.
5. If you haven't been trained in CPR, continue chest compressions until there are
signs of movement or until emergency medical personnel take over. If you have
been trained in CPR, go on to opening the airway and rescue breathing.
Airway: Open the airway

 If you're trained in CPR and you've performed 30 chest compressions, open the
person's airway using the head-tilt, chin-lift maneuver. Put your palm on the
person's forehead and gently tilt the head back. Then with the other hand, gently lift
the chin forward to open the airway.
Breathing: Breathe for the person
Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the
mouth is seriously injured or can't be opened.

1. With the airway open (using the head-tilt, chin-lift maneuver), pinch the nostrils
shut for mouth-to-mouth breathing and cover the person's mouth with yours,
making a seal.
2. Prepare to give two rescue breaths. Give the first rescue breath — lasting one
second — and watch to see if the chest rises. If it does rise, give the second
breath. If the chest doesn't rise, repeat the head-tilt, chin-lift maneuver and then
give the second breath. Thirty chest compressions followed by two rescue breaths
is considered one cycle. Be careful not to provide too many breaths or to breathe
with too much force.
3. Resume chest compressions to restore circulation.
4. As soon as an automated external defibrillator (AED) is available, apply it and
follow the prompts. Administer one shock, then resume CPR — starting with chest
compressions — for two more minutes before administering a second shock. If
you're not trained to use an AED, a 911 or other emergency medical operator may
be able to guide you in its use. If an AED isn't available, go to step 5 below.
 5. Continue CPR until there are signs of movement or emergency medical
personnel take over.

To perform CPR on a child

The procedure for giving CPR to a child age 1 through puberty is essentially the same
as that for an adult. The American Heart Association also recommends the following to
perform CPR on a child:
Compressions: Restore blood circulation
If you are alone and didn't see the child collapse, perform five cycles of compressions
and breaths on the child — this should take about two minutes — before calling 911 or
your local emergency number and getting the AED, if one is available.
If you're alone and you did see the child collapse, call 911 or your local emergency
number and get the AED, if one is available, before beginning CPR. If another person
is available, have that person call for help and get the AED while you begin CPR.

1. Put the child on his or her back on a firm surface.

2. Kneel next to the child's neck and shoulders.
3. Use two hands, or only one hand if the child is very small, to perform chest
compressions. Press straight down on (compress) the chest about 2 inches
(approximately 5 centimeters). If the child is an adolescent, push straight down on
the chest at least 2 inches (approximately 5 centimeters) but not greater than 2.4
inches (approximately 6 centimeters). Push hard at a rate of 100 to 120
compressions a minute.
4. If you haven't been trained in CPR, continue chest compressions until there are
signs of movement or until emergency medical personnel take over. If you have
been trained in CPR, go on to opening the airway and rescue breathing.
Airway: Open the airway

 If you're trained in CPR and you've performed 30 chest compressions, open the
child's airway using the head-tilt, chin-lift manoeuvre. Put your palm on the child's
forehead and gently tilt the head back. Then with the other hand, gently lift the chin
forward to open the airway.
Breathing: Breathe for the child
Use the same compression-breath rate that is used for adults: 30 compressions
followed by two breaths. This is one cycle.

1. With the airway open (using the head-tilt, chin-lift manoeuvre), pinch the nostrils
shut for mouth-to-mouth breathing and cover the child's mouth with yours, making
a seal.
 2.
Prepare to give two rescue breaths. Give the first rescue breath — lasting one
second — and watch to see if the chest rises. If it does rise, give the second
breath. If the chest doesn't rise, repeat the head-tilt, chin-lift manoeuvre and then
give the second breath. Be careful not to provide too many breaths or to breathe
with too much force.
3. After the two breaths, immediately begin the next cycle of compressions and
breaths. If there are two people performing CPR, conduct 15 compressions
followed by two breaths.
4. As soon as an AED is available, apply it and follow the prompts. Use pediatric
pads if available, for children up to age 8. If pediatric pads aren't available, use
adult pads. Administer one shock, then resume CPR — starting with chest
compressions — for two more minutes before administering a second shock. If
you're not trained to use an AED, a 911 or other emergency medical operator may
be able to guide you in its use.
Continue until the child moves or help arrives.
To perform CPR on a baby 4 weeks old and older
Most cardiac arrests in babies occur from lack of oxygen, such as from drowning or
choking. If you know the baby has an airway obstruction, perform first aid for choking. If
you don't know why the baby isn't breathing, perform CPR.
To begin, examine the situation. Stroke the baby and watch for a response, such as
movement, but don't shake the baby.
If there's no response, follow the C-A-B procedures below for a baby under age 1
(except newborns, which includes babies up to 4 weeks old) and time the call for help
as follows:

 If you're the only rescuer and you didn't see the baby collapse, do CPR for two
minutes — about five cycles — before calling 911 or your local emergency number
and getting the AED. If you did see the baby collapse, call 911 or your local
emergency number and get the AED, if one is available, before beginning CPR.
 If another person is available, have that person call for help immediately and get
the AED while you attend to the baby.
Compressions: Restore blood circulation

1. Place the baby on his or her back on a firm, flat surface, such as a table. The
floor or ground also will do.
2. Imagine a horizontal line drawn between the baby's nipples. Place two fingers of
one hand just below this line, in the center of the chest.
 3. Gently compress the chest about 1.5 inches (about 4 centimeters).
4. Count aloud as you pump in a fairly rapid rhythm. You should pump at a rate of
100 to 120 compressions a minute.

Airway: Open the airway

 After 30 compressions, gently tip the head back by lifting the chin with one hand
and pushing down on the forehead with the other hand.

Breathing: Breathe for the baby

1. Cover the baby's mouth and nose with your mouth.

2. Prepare to give two rescue breaths. Use the strength of your cheeks to deliver
gentle puffs of air (instead of deep breaths from your lungs) to slowly breathe into
the baby's mouth one time, taking one second for the breath. Watch to see if the
baby's chest rises. If it does, give a second rescue breath. If the chest does not
rise, repeat the head-tilt, chin-lift maneuver and then give the second breath.
3. If the baby's chest still doesn't rise, continue chest compressions.
4. Give two breaths after every 30 chest compressions. If two people are
conducting CPR, give two breaths after every 15 chest compressions.
5. Perform CPR for about two minutes before calling for help unless someone else
can make the call while you attend to the infant.
6. Continue CPR until you see signs of life or until medical personnel arrive.